Our Summary

Rotator cuff injuries, which often reoccur after surgery, are a significant health issue. This high rate of recurrence is because the repaired tissue fails to regenerate the original tendon-to-bone connection. Current methods of enhancement, like grafts, pose risks such as tissue damage at the donor site, immune reactions, and disease transmission. An alternative approach, using growth factor therapy, could lower these risks by actively promoting better healing. However, there are challenges such as choosing the best growth factors, timing, and delivery device. Advances in our understanding of the healing process and growth factors are helping in developing better delivery methods to treat rotator cuff tears effectively. This paper reviews potential growth factors, design considerations, and innovative methods for delivery, as well as new therapeutic targets for improving the healing of rotator cuff repairs.

FAQs

  1. Why are rotator cuff injuries likely to reoccur after surgery?
  2. What are the potential risks associated with the use of grafts in rotator cuff repair?
  3. How could growth factor therapy potentially improve the healing process of rotator cuff repairs?

Doctor’s Tip

One helpful tip a doctor might tell a patient about rotator cuff repair is to follow a comprehensive rehabilitation program after surgery. This program typically includes physical therapy exercises to help improve strength, flexibility, and range of motion in the shoulder. It is important for patients to diligently follow their physical therapy regimen to ensure the best possible outcome and reduce the risk of re-injury. Additionally, patients should avoid activities that may put excessive strain on the shoulder during the healing process to allow for optimal recovery.

Suitable For

Patients who are typically recommended rotator cuff repair are those who have a torn rotator cuff, which can be caused by acute injury, repetitive overhead motions, or degenerative changes in the tendon. These patients may experience symptoms such as pain, weakness, and limited range of motion in the shoulder.

Rotator cuff repair surgery is often recommended for patients who have not seen improvement with conservative treatments such as rest, physical therapy, and anti-inflammatory medications. Additionally, patients who have a large or complete tear of the rotator cuff, or who have significant symptoms that impact their daily activities and quality of life, may be good candidates for surgery.

It is important for patients to discuss their individual situation with their healthcare provider to determine if rotator cuff repair is the best treatment option for them. Factors such as the size and location of the tear, the patient’s overall health and activity level, and their treatment goals will all be considered in making this decision.

Timeline

Before rotator cuff repair:

  1. Injury: The patient experiences pain, weakness, and limited mobility in the shoulder due to a rotator cuff tear.
  2. Diagnosis: The patient undergoes imaging tests such as MRI or ultrasound to confirm the diagnosis of a rotator cuff tear.
  3. Non-surgical treatment: The patient may undergo physical therapy, corticosteroid injections, and rest to manage symptoms before considering surgery.

After rotator cuff repair:

  1. Surgery: The patient undergoes arthroscopic or open surgery to repair the torn rotator cuff tendon.
  2. Rehabilitation: The patient undergoes a structured rehabilitation program to regain strength and range of motion in the shoulder.
  3. Follow-up appointments: The patient follows up with the surgeon for post-operative check-ups and monitoring of progress.
  4. Recurrence prevention: The patient may be advised to avoid certain activities or make lifestyle changes to prevent re-injury of the rotator cuff.
  5. Potential complications: The patient may experience complications such as infection, stiffness, or re-tear of the repaired tendon, which may require further treatment.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with rotator cuff repair surgery?
  2. What is the success rate of rotator cuff repair surgery, and what is the likelihood of the injury reoccurring?
  3. Are there alternative treatments or therapies available for rotator cuff injuries besides surgery?
  4. How long is the recovery process after rotator cuff repair surgery, and what can I expect in terms of pain and mobility during this time?
  5. Are there any specific exercises or physical therapy techniques that can help improve the strength and flexibility of my shoulder after surgery?
  6. What growth factors or regenerative therapies are available for enhancing the healing process of rotator cuff repairs, and how effective are they?
  7. What are the potential benefits of using growth factor therapy for rotator cuff repair, and are there any risks or side effects associated with this treatment?
  8. How will the growth factors be delivered to the injured area during the surgery, and what is the expected outcome of this treatment?
  9. What is the overall prognosis for my rotator cuff injury, and what steps can I take to help prevent future injuries or retears?
  10. Are there any ongoing research studies or clinical trials investigating new treatments or advancements in rotator cuff repair that I should be aware of?

Reference

Authors: Prabhath A, Vernekar VN, Sanchez E, Laurencin CT. Journal: Int J Pharm. 2018 Jun 15;544(2):358-371. doi: 10.1016/j.ijpharm.2018.01.006. Epub 2018 Jan 6. PMID: 29317260